Duty of care: Donation receipt / transfer note
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Section A - Current Holder of the waste - Transferor / Transfer
By signing in Section D below I confirm that I have fulfilled my duty to apply the waste hierarchy as required by Regulation 12 of the Waste (England and Wales) Regulations 2011
A1 - Full name
Find Address
A2 - Are you:
The producer of the waste?
Yes
No
The importer of the waste?
Yes
No
The local authority?
Yes
No
The holder of an environmental permit?
Yes
No
Registered waste exemption?
Yes
No
Section B - Person collecting the waste - Transferee
B1 - Full name
Find Address
B2 - Are you:
The local authority?
Yes
No
B3 - Are you:
Registered waste exemption?
Yes
No
A registered waste carrier, broker or dealer?
Yes
No
Details (are you a carrier, broker or dealer?)
T11 Exemption & ATF
Section C - Data
C1 - Data Collection and Data control:
HDD
USB Flash Pens
SD and Flash Memory
Onsite removal?
Yes
No
3 Pass Wipe?
Yes
No
Shred?
Yes
No
Section D - Description of waste/donation
D1 Description of the waste/donation being transferred including weight and EWC codes:
Are the following items Donated?
Yes
No
Are the following items electrical waste?
Yes
No
ITEM
WASTE TYPE INC EWC
QUANTITY
WEIGHT (KG)
Select Waste Type
Batteries (vehicle) -160601
Batteries (other) - 200133
Computer Keyboards - 160214
Computers & TFT - 160213
Cookers & Microwaves - 160214
White Goods Hazard - 200135
White Goods Non Hazards - 200136
TVs Laptops Mobiles - 200135
Select Waste Type
Batteries (vehicle) -160601
Batteries (other) - 200133
Computer Keyboards - 160214
Computers & TFT - 160213
Cookers & Microwaves - 160214
White Goods Hazard - 200135
White Goods Non Hazards - 200136
TVs Laptops Mobiles - 200135
Select Waste Type
Batteries (vehicle) -160601
Batteries (other) - 200133
Computer Keyboards - 160214
Computers & TFT - 160213
Cookers & Microwaves - 160214
White Goods Hazard - 200135
White Goods Non Hazards - 200136
TVs Laptops Mobiles - 200135
Select Waste Type
Batteries (vehicle) -160601
Batteries (other) - 200133
Computer Keyboards - 160214
Computers & TFT - 160213
Cookers & Microwaves - 160214
White Goods Hazard - 200135
White Goods Non Hazards - 200136
TVs Laptops Mobiles - 200135
Add New Item
TAG SERIAL NUMBER
HDD SERIAL NUMBER
Add New HDD
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